Kirkaldy-Willis and Cassidy study on chronic low back pain

A population of 283 chronic LBP patients disabled from work or other activities by constant, severe pain for an average of approximately 8 years, and referred to a hospital orthopaedic department after failing to respond to various treatments, were assessed for specific joint dysfunction by a chiropractor (e.g. posterior joint syndrome, sacroiliac joint syndrome). Those found to have joint dysfunction/subluxation received daily spinal manipulation from an experienced chiropractor, encouragement, education and advice.

* For the 171 patients with posterior joint syndrome and/or sacroiliac syndrome, each had been disabled by pain for an average of 8 years. Following the 2 to 3 week regime of daily adjustments 87% returned to full function with no restrictions for work or other activities. No patient was made worse. The 87% success rate was maintained when the patients were reviewed after 12 months. Some had had a further short course of manipulation/adjustement during the follow-up period.

* In a sub-group of 11 patients with clear evidence on imaging of central spinal stenosis, but also evidence of specific joint dysfunction on a chiropractic diagnosis, four (36%) were returned tot full function within 2 to 3 weeks following a course of chiropractic adjustement. This recovery rate was maintained at 7 months follow-up. Notably, this group of patients had experienced average total disbility from chronic back and leg pain for 16.9 years. Kirkaldy-Willis and Cassidy’s explanation is that the pain and disability apparently arose from the functional problem (joint dysfunction) rather than the structural one (central stenosis)

Kirkaldy-Willis and Cassisy JD, Canadian Family Physician, 1985

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